2017 Volume 53 Issue 1 Pages 38-42
Purpose: In Japan, although cases of epigastric hernia (EH) are rare in adults, there are actually many such cases in children. We focus on the cause of this difference by reviewing the clinical features of our pediatric and adult cases.
Methods: By using data from 6 pediatric surgery departments belonging to the Chugoku-Shikoku Pediatric Surgical Partners Organization and 6 surgery departments in the same hospitals, medical records were reviewed for patients who were operated on for EH from April 2005 to March 2014.
Results: Eighty-seven cases of EH (76 children and 11 adults) were evaluated. There were 37 male and 50 female patients. The pediatric patients were concentrated in the infancy age group, and the adult patients were distributed evenly across all age groups. All children, except for 3 patients, were asymptomatic, whereas 8 out of 11 adult patients complained of pain. The operation was mainly performed within a few years after diagnosis. The diameters of the defects are 10 mm or less in children and 20 mm or more in adults. The hernia contained only preperitoneal fat in most of the children and mainly omentum in the adults. All hernias were repaired with interrupted sutures without recurrence.
Conclusions: The difference in the number of reported EH cases between adults and children is due to the operative indication. The future risk of hernia incarceration in asymptomatic EH children tends to be overestimated, in light of the fact that there are only few symptomatic cases found in adults. In conclusion, an operative indication for infants with asymptomatic EH may be debatable.
